Vascular Surgery NW PS

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VASCULAR SURGERY NW PS

Practice address

11311 Bridgeport Way SW
#203
Lakewood, WA 98499

Phone

(253) 572-2844

Fax

(253) 572-2841

NPI assigned

Feb 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allen HB Yu, MD

Title

President

Phone

(253) 572-2844

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natasha Tininenko, DPT

  • Physical Therapist
  • San Diego, CA
  • NPI 1225170087
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1780657924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY SW",
            "address_2": "#203",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-572-2844",
            "fax_number": "253-572-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY SW",
            "address_2": "#203",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-572-2844",
            "fax_number": "253-572-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY NW PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "YU",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "HB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-572-2844",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7076797",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "0430430",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brock Van Dyke
• Veronica June Capitelli Van Essche, MA, LMFT
• Joanne Tu-Ozo Van Kirk, AA
• Paula G. Van Pul, M.A.
• Pamela Kay Vandenberg, L.M.P.
• Douglas Duffield Vaskas, M.ED.
• Patrick J Vaughan, MD
• Nicole Marie Vaughn
• Olivia C Vaughn
• Marilyn Veasley-Gagner, BA

• Vascular Surgery Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Vascular Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.